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Statins for primary prevention of cardiovascular disease: the benefits outweigh the risks.
Curr Opin Cardiol 2013; 28(5):554-60CO

Abstract

PURPOSE OF REVIEW

Statins significantly reduce cardiovascular morbidity and mortality in patients with and without coronary heart disease. Recently, much debate has focused on use of statins for primary prevention following a class-wide safety label change by the US Food and Drug Administration amidst concerns of worsened hyperglycemia. Here, we review the evidence for statins in primary prevention and offer guidance for their appropriate use.

RECENT FINDINGS

Two meta-analyses published since 2012 unequivocally support statins for primary prevention. Data from the Cholesterol Treatment Trialists' Collaborators demonstrated a 9% [relative risk (RR) 0.91, 95% confidence interval (CI) 0.85-0.97] reduction in all-cause mortality and a 25% (RR 0.75, 95% CI 0.70-0.80) reduction in major vascular events per 1.0 mmol/l reduction in low-density lipoprotein cholesterol, even among low-risk patients. A 2013 Cochrane review corroborated these findings including a 14% (OR 0.86, 95% CI 0.79-0.94) reduction in all-cause mortality and a 25% (RR 0.75, 95% CI 0.70-0.81) reduction in cardiovascular disease events with statin therapy despite an 18% (RR 1.18, 95% CI 1.01-1.39) increase in incident diabetes.

SUMMARY

Statins effectively lower atherogenic lipoproteins and result in clinically significant reductions in cardiovascular morbidity and mortality. When well tolerated, the cardiovascular benefits of statins for primary prevention generally far outweigh the reported harms.

Authors+Show Affiliations

The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Maryland 21287, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

23928920

Citation

Minder, C Michael, et al. "Statins for Primary Prevention of Cardiovascular Disease: the Benefits Outweigh the Risks." Current Opinion in Cardiology, vol. 28, no. 5, 2013, pp. 554-60.
Minder CM, Blumenthal RS, Blaha MJ. Statins for primary prevention of cardiovascular disease: the benefits outweigh the risks. Curr Opin Cardiol. 2013;28(5):554-60.
Minder, C. M., Blumenthal, R. S., & Blaha, M. J. (2013). Statins for primary prevention of cardiovascular disease: the benefits outweigh the risks. Current Opinion in Cardiology, 28(5), pp. 554-60. doi:10.1097/HCO.0b013e32836429e6.
Minder CM, Blumenthal RS, Blaha MJ. Statins for Primary Prevention of Cardiovascular Disease: the Benefits Outweigh the Risks. Curr Opin Cardiol. 2013;28(5):554-60. PubMed PMID: 23928920.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Statins for primary prevention of cardiovascular disease: the benefits outweigh the risks. AU - Minder,C Michael, AU - Blumenthal,Roger S, AU - Blaha,Michael J, PY - 2013/8/10/entrez PY - 2013/8/10/pubmed PY - 2014/3/19/medline SP - 554 EP - 60 JF - Current opinion in cardiology JO - Curr. Opin. Cardiol. VL - 28 IS - 5 N2 - PURPOSE OF REVIEW: Statins significantly reduce cardiovascular morbidity and mortality in patients with and without coronary heart disease. Recently, much debate has focused on use of statins for primary prevention following a class-wide safety label change by the US Food and Drug Administration amidst concerns of worsened hyperglycemia. Here, we review the evidence for statins in primary prevention and offer guidance for their appropriate use. RECENT FINDINGS: Two meta-analyses published since 2012 unequivocally support statins for primary prevention. Data from the Cholesterol Treatment Trialists' Collaborators demonstrated a 9% [relative risk (RR) 0.91, 95% confidence interval (CI) 0.85-0.97] reduction in all-cause mortality and a 25% (RR 0.75, 95% CI 0.70-0.80) reduction in major vascular events per 1.0 mmol/l reduction in low-density lipoprotein cholesterol, even among low-risk patients. A 2013 Cochrane review corroborated these findings including a 14% (OR 0.86, 95% CI 0.79-0.94) reduction in all-cause mortality and a 25% (RR 0.75, 95% CI 0.70-0.81) reduction in cardiovascular disease events with statin therapy despite an 18% (RR 1.18, 95% CI 1.01-1.39) increase in incident diabetes. SUMMARY: Statins effectively lower atherogenic lipoproteins and result in clinically significant reductions in cardiovascular morbidity and mortality. When well tolerated, the cardiovascular benefits of statins for primary prevention generally far outweigh the reported harms. SN - 1531-7080 UR - https://www.unboundmedicine.com/medline/citation/23928920/Statins_for_primary_prevention_of_cardiovascular_disease:_the_benefits_outweigh_the_risks_ L2 - http://Insights.ovid.com/pubmed?pmid=23928920 DB - PRIME DP - Unbound Medicine ER -